The Alliance for Health Policy and Systems Research convened an inception workshop at the beginning of May to launch a new portfolio of implementation research projects focused on strengthening noncommunicable disease service delivery. In collaboration with WHO Department of Noncommunicable Diseases, Rehabilitation and Disability, the Alliance is supporting eight country teams to conduct this research through April 2027, with four of these projects building on earlier work initiated in 2023.
Hosted at the National Institute of Public Health (NIPH) in Phnom Penh, Cambodia, the three-day workshop brought together researchers, policy-makers, experts, WHO country and regional offices and team members from the eight countries – Cambodia, Ethiopia, Ghana, India, Indonesia, Morocco, Nepal and Sri Lanka. The meeting was officially opened by Secretary of State of Cambodia’s Ministry of Health, Professor Lem Dara, NIPH Director, Professor Chhea Chhorvann, and Dr Kumanan Rasanathan, Alliance Executive Director, alongside Dr Ada Moadsiri and Dr Sam Ath Khim, from WHO Country Office for Cambodia, and Dr Chhun Loun, the noncommunicable disease focal point at the ministry.
During the workshop, participants explored how embedded implementation research can address the complex challenges of delivering care for noncommunicable diseases in low- and middle-income countries, many of which are grappling with multiple and intersecting burdens on their health systems.
“Implementation research gives us tools to bridge the know-do gap for noncommunicable diseases,” said Dr Kumanan Rasanathan, Executive Director of the Alliance. “Our goal is to generate research that directly improves service delivery and informs scalable, context-appropriate models of care for noncommunicable diseases in low- and middle-income countries.”
Aligning research with country priorities
The eight country-led implementation research projects are grounded in national priorities and focused on WHO frameworks and tools such as the package for essential noncommunicable diseases (PEN) interventions and the HEARTS technical package for cardiovascular disease interventions in primary health care.
During the workshop, each country team presented their project focus, study design and strategies to ensure policy relevance and real-world impact, summarized below:
- National Institute of Public Health, Cambodia: Building on previous work, the team will examine barriers and enablers to scaling integrated diabetes and hypertension care.
- University of Gondar, Ethiopia: This study evaluates scale-up of a three-in-one package for hypertension, diabetes and cervical cancer using service and outcome indicators.
- University of Ghana, Ghana: A cluster-randomized control trial will assess whether integrating noncommunicable disease and HIV services at primary level improves access, awareness and efficiency.
- Amrita Institute of Medical Sciences, India: A culturally tailored lifestyle intervention using mHealth and community volunteers aims to reduce cardiometabolic multimorbidity, tested through a type III implementation-effectiveness study.
- Center for Indonesia’s Strategic Development Initiatives, Indonesia: Evaluating the national programme on integrated services against PEN and HEARTS standards, this research will offer recommendations for scaling up integrated care.
- Mohammed VI Centre for Research and Innovation, Morocco: Embedded implementation research will track the national scale-up of the HEARTS programme to enhance cardiovascular disease prevention and stakeholder capacity.
- Institute for Implementation Science and Health, Nepal: A type II hybrid effectiveness-implementation study will test task-shifting to female community health workers for hypertension and diabetes management.
- Institute for Health Policy, Sri Lanka: Using available survey data and a mixed-methods approach, the study aims to inform policy reform and reduce treatment-control gaps in diabetes and hypertension.
Framing policy engagement and equity
Across sessions, participants reflected on the importance of involving implementers, policy-makers and community actors early and regularly, and discussed challenges like medicines availability, referral systems, private sector engagement and equity gaps in service access. Dr Kremlin Wickramasinghe, who joined from the WHO Regional Office for Europe, emphasized that implementation research must translate real-world challenges into practical research questions to enable more effective policy and programme adaptation for noncommunicable diseases.
The meeting emphasized that institutionalizing implementation research means going beyond individual capacity to strengthen organizational systems and networks.
“Equity must be central in implementation science,” noted Professor Yodi Mahendradhata of Universitas Gadjah Mada, Indonesia. “Frameworks need to be questioned, adapted and used with transparency, especially in low- and middle-income country contexts.”
Toward a collaborative learning platform
The workshop included group discussions on evidence-to-policy translation, stakeholder mapping and involvement, and sustainability of research. Teams committed to share data collection tools, share protocols, and co-author outputs across countries and discussed how to strengthen their collective capacity and contribute to improving service delivery for noncommunicable diseases.
“We do not need perfect policies to achieve impact,” said Dr Walaiporn Patcharanarumol of Thailand’s International Health Policy Program, sharing lessons from her country’s decades-long health reform process. “We must be realistic, not just ambitious. Building long-term change requires continuous engagement, trusted relationships, and policy-relevant evidence that aligns with what countries want and are ready to act on.”
The projects, set to run over the next two years, aim to generate evidence to enhance service delivery and inform effective models of care for chronic conditions, and ultimately improve health outcomes for people living with noncommunicable diseases in low- and middle-income countries.